A permanent solution to the annual cuts to Medicare physician reimbursement rates through the sustainable growth rate formula “doc fix” may be in jeopardy due to upcoming budget negotiations.
Congress for the past decade has approved last-minute patches to scheduled cuts under the SGR formula.
The House Ways and Means and Energy and Commerce committees seemed to be moving forward with creating a permanent plan. In August, the Energy and Commerce Committee approved a bipartisan SGR replacement plan (H.R. 2810).
The chance to pass legislation this year was high because estimates for the cost of such legislation were far lower than in previous years. The Congressional Budget Office estimated the total cost of the legislation developed by the Energy and Commerce Committee would be $175.5 billion over a decade rather than the $300 billion estimate in previous years.
However, committee members are worried the opportunity for the legislation might be lost in upcoming fiscal negotiations, which could be similar to those that caused the recent government shutdown. Finding ways to offset the $175.5 billion price tag could prove difficult amid budget negotiations in which some lawmakers will be looking to make significant cuts.